Format

Send to

Choose Destination
Dig Dis Sci. 2018 Feb;63(2):429-436. doi: 10.1007/s10620-017-4893-3. Epub 2018 Jan 4.

Exploring Gut Microbiota Composition as an Indicator of Clinical Response to Dietary FODMAP Restriction in Patients with Irritable Bowel Syndrome.

Author information

1
Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, Lovisenberggata 21, 0440, Oslo, Norway. jorgen.valeur@lds.no.
2
Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
3
Department of Clinical Nutrition, Lovisenberg Diaconal Hospital, Oslo, Norway.
4
Department of Clinical Medicine, Center for Nutrition, University of Bergen, Bergen, Norway.
5
Department of Medicine, Section of Gastroenterology, Haukeland University Hospital, Bergen, Norway.
6
Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway.

Abstract

BACKGROUND:

A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) may relieve symptoms of irritable bowel syndrome (IBS). However, nutritional counseling is resource-demanding and not all patients will benefit.

AIMS:

To explore whether gut microbial composition may identify symptom response to a low-FODMAP diet in patients with IBS.

METHODS:

Patients were recruited consecutively to participate in a 4-week FODMAP-restricted diet. Response to diet was defined as ≥ 50% decrease in IBS symptom severity scores (IBS-SSS) compared to baseline. Fecal microbiota were analyzed by a commercially available method (the GA-map™ Dysbiosis Test), assessing 54 bacterial markers targeting more than 300 bacteria at different taxonomic levels.

RESULTS:

Sixty-one patients (54 F; 7 M) were included: 32 (29 F; 3 M) classified as responders and 29 (25 F; 4 M) as non-responders. Ten of the 54 bacterial markers differed significantly between responders and non-responders. Based on median values (used as cutoff) of responders for these 10 bacterial markers, we constructed a Response Index (RI): Each patient was given a point when the value for each selected bacterial marker differed from the cutoff. These points were summed up, giving an RI from 0 to 10. Patients with RI > 3 were 5 times more likely to respond (OR = 5.05, 95% CI [1.58; 16.10]), and the probability to respond was 83.4%, 95% CI [61.2-94%].

CONCLUSIONS:

Gut microbial composition, assessed by using a new RI, may constitute a tool to identify patients that are likely to respond to dietary FODMAP restriction.

KEYWORDS:

Clinical nutrition; Functional gastrointestinal disorders; Gut microbiome; Irritable bowel severity scoring system

PMID:
29302878
DOI:
10.1007/s10620-017-4893-3
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center